Provider Demographics
NPI:1447382304
Name:AVENT, PEGGY JEANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:JEANNE
Last Name:AVENT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 HIDDEN DR
Mailing Address - Street 2:B5
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4658
Mailing Address - Country:US
Mailing Address - Phone:210-655-5958
Mailing Address - Fax:210-655-0431
Practice Address - Street 1:3605 HIDDEN DR
Practice Address - Street 2:B5
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4658
Practice Address - Country:US
Practice Address - Phone:210-655-5958
Practice Address - Fax:210-655-0431
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08401101YP2500X
TX2211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034342OtherVALUE OPTIONS
TX1018LCOtherBLUE CROSS BLUE SHIELD